Provider Demographics
NPI:1962771618
Name:CAO, ANH QUYNH (RPH)
Entity type:Individual
Prefix:MS
First Name:ANH
Middle Name:QUYNH
Last Name:CAO
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8030 HORSE FERRY RD
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32835-5976
Mailing Address - Country:US
Mailing Address - Phone:407-290-5812
Mailing Address - Fax:
Practice Address - Street 1:12650 INTERNATIONAL DR S
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32821-6942
Practice Address - Country:US
Practice Address - Phone:407-238-4677
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-12-27
Last Update Date:2011-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS36216183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist